Research presented at an Emergency Radiology (Abdominal Emergencies) Scientific Assembly at the Radiological Society of North America Annual Meeting (RSNA) 2014 shows that in adult patients, CT of the abdomen with Right Lower Quadrant (RLQ) compression can give an accurate diagnosis of acute appendicitis. CT with RLQ compression is similar to graded compression used in ultrasound diagnoses.
The study included a total of 168 patients with suspected appendicitis, aged between 18–78 years. Seventy-one patients underwent contrast enhanced CT with compression to the RLQ, while 97 were examined using a standard CT protocol. Compression was applied with an elastic belt and a 1 L saline bag. The CT Images were reviewed in consensus by two radiologists. Fifty-nine patients were found to have pathologically proven acute appendicitis, 23 with RLQ compression, and 36 with standard protocol.
The study found that abdominal CT combined with RLQ compression of the lower abdomen leads to a highly accurate diagnosis of acute appendicitis. Normal appendix diameter was significantly smaller in patients with RLQ than with the standard CT control group, and more contrast material entered the appendiceal lumen in patients with RLQ than those in the standard CT group.
The study was carried out by Dr. Erhan Akpinar et al of the radiology department at the Hacettepe University in Ankara (Turkey).